Nursing Committee Updates
Practice Committee
The May meeting of the Practice Committee was devoted to celebrating the publication of the second edition of “Clinical Wisdom and Interventions in Acute and Critical Care” by Patricia Benner, PhD, RN; Patricia Hooper Kyriakidis, PhD, RN; and Daphne Stannard, PhD, RN. Dr. Kyriakidis has provided consultation to the committee since its beginning and the narratives of four BWH nurses – Beth Baldwin, RN, nurse educator, MaryAnne Bennett, RN, NICU, Andrea Edmands, RN, Burn/Trauma, and Corrine Cyr Pryor, RNC, NICU – are featured in the book. The celebration included a presentation by and conversation with Beth Baldwin and Andrea Edmands of their narratives that appear in the book. A book-signing followed the discussion.
For committee members, the presentation and discussion of narratives was very timely. Part of advancing professional practice is building a reflective practice and a goal of the committee is to identify strategies that will support narrative development throughout the organization. With the guidance of Dr. Kyriakidis, committee members are learning skills related to eliciting and discussing narratives.
If you have questions, contact committee co-chairs Mary Beth Mondello, MSN, CNRC, NP-C, and Alice O’Brien, MS, RN.
Standards Policies and Procedures Committee
In June, the committee said goodbye to advisor Barbara Bauman, who has been with the committee since it was restructured three years ago. Barbara’s leadership brought knowledge, humor and perspective that always helped inform the committee’s work and the process. As members wished Barbara farewell, they also welcomed their new advisor, Laura Mylott, PhD, RN, executive director of the Center for Nursing Excellence. The committee looks forward to working with Laura and to a new chapter in fulfilling its charge.
Committee Highlights:
Policy IVT-01: IV tubing and solutions cannot be transferred between central and peripheral lines (except in emergencies). Also, the following relates to the use and tracking of powerport lumens for CT/MRI use:
Central Catheters
A. The ARROWgard® multilumen central catheter is pressure-injectable and can be used for power-injecting contrast media for CT and MRI exams. Given that the ARROWgard is limited to 10 power-injections only per catheter, a tracking of the number of power-injections per catheter is to be done by Nursing and Radiology on the ARROWgard Multilumen Pressure Injectable Central Venous Catheter Log Sheet, which is housed in the Graphic Records section of the patient’s chart. Nursing should:
B. All other power-injectable central catheters: It is not necessary to track power-injections per catheter for PICCs, ports, or tunneled power lines as there is no limit on power-injections for these catheters.
As always, please email your comments, questions and concerns to co-chairs Sharon Swan, RN, and Cindy Jodoin, RN.
Patient Family Education Committee
The Patient and Family Education Committee continued work with the Acute Care Documentation Committee on the redesign of patient education documentation.
Additional committee work includes: ongoing updates of the Patient Education Website, review and revision of the Nurse to Nurse button which will include organizing resources by building, and review of the newly revised Information for Families and Friends booklet, which the committee helped to refine.
The committee had the opportunity to meet with Yilu Ma, the new director for Interpreter Services. He was able to share information regarding the new interpreter phones that have been made available throughout the Tower and discuss how technology is improving our access to Interpreter Services.
In May, the committee reviewed the final changes made to improve patient education documentation at the bottom of the flow sheet, which has gone to print. The committee also welcomed Katie Fillipon, RN, nurse director of Tower 7A and 7B, as its new co-chair. Katie replaces Cindy Loring, RN, nurse educator of CWN-10, who has been co-chair since the Department of Nursing committee restructuring three years ago. The committee thanked Cindy for her leadership and many contributions to its success.
With questions, please contact co-chairs Deb Moody, RN, and Katie Fillipon, RN.
Quality, Safety and Care Improvement Committee
The QSCI committee welcomes Deborah Mulloy, PhD, RN, the new executive director of Nursing Quality Measurement and Improvement as committee advisor. Deb brings a wealth of knowledge and experience as she guides the committee to advance its commitment to the continuous improvement of patient-family centered care, quality and safety.
Committee Highlights include:
- Pressure ulcer prevalence rates have continued to decline with the prevalence rate of 5.6 percent recently reported at a committee meeting by Susan Kilroy, MSN, RN, program director. Of the pressure ulcers identified, 3.5 percent were present on admission, while only 2.1 percent were hospital-acquired. The majority of hospital-acquired pressure ulcers were stage two. To continue to improve patient outcomes, the hospital plans to participate in a Partners-wide trial to examine absorbent and launderable linen pads. Stay tuned for more information on this trial.
Hand Hygiene: Nurses and PCAs continue to maintain high rates of compliance (92-100 percent). All colleagues are encouraged to work towards sustainable improvement. The Infection Control Department with the support of Materials Management is sponsoring a “BWH Hand Hygiene Awareness Day” on Friday, July 15, from 8 a.m. to 3 p.m. on the Pike across from the gift shop. All nurses are encouraged to stop by and help promote hand hygiene at BWH.
Please contact a committee member or committee co-chairs Stephanie Capello, RN, or Martha Doherty, RN, if you have a question, suggestion or issue. A committee goal is to partner with staff to bring forward quality and safety issues impacting patient care or nursing practice. The QSCI committee meets the second Tuesday of every month from 3:30 to 5:30 p.m. in the PCS conference room.
Informatics and Clinical Innovations Committee:
The Informatics and Clinical Innovations Committee continues to advocate for clinical systems projects to support the work of the nurse at the bedside and promote patient and staff safety. The committee welcomed former member Gary Zina, RN, into the co-chair role as it said good-bye to Carol Booth, RN, who has been co-chair since the committee’s inception three years ago. The committee thanked Carol for her leadership and looks forward to her continued participation as a committee member. The work of the committee continues with the following initiatives:
- Online Nursing Sign-Out Pilot: A new web-based, online nursing sign-out is being trialed on 4B. The sign out contains interdisciplinary patient data and can pull information from other systems such as BICs, eMAR, allergy repository, LMR and lab data. RNs add acuity data and d/c planning information.
New Discharge Module: Our new BWH discharge documentation module will be implemented in the late fall. A demonstration was presented to the committee for feedback on how best to prepare nurses to use the module.
PEPL/Responding Clinician: The responding clinician icon now displays more complete information. When you click on the icon, you can see names of both the sub intern (if a patient is assigned a Sub-I) and MD that are covering the patient. A sub intern is a fourth-year medical student who writes orders that need to be co-signed before they can be acted upon by the nurse.
Alaris pumps: The last Alaris library update occurred on 04/11/11. You should see this date in the upper left corner of the “brain.” This update reflects the recent drug package changes such as calcium chloride (a more potent drug) which has taken the place of calcium gluconate due to a national shortage. If the pump does not show the most recent update, please place a “yellow” repair tag on it and send the pump to bio-med to be upgraded.
Omnicell Cabinets: The committee identified a knowledge gap in the use of the Omnicell cabinet and made recommendations on how to educate staff. When removing multiple items from the refrigerator, the “green/next” button must be selected as the individual products are removed to insure the proper charge for each drug. Patients are charged based on meds removed from the Omnicell, not by scanning the med in eMAR. If you have questions regarding the Omnicell cabinet, contact your leadership team.
Please contact co-chairs Heidi Smith Doucette, CNRN, or Gary Zina, RN, with questions.